Peritoneal Dialysis Solution Composition for Ultrafiltration Failure
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Solution Overview
Problem
Conventional peritoneal dialysis solutions cause membrane toxicity and ultrafiltration failure due to high glucose content, leading to impaired osmotic conductance and reduced solute and fluid removal, with limited evidence supporting biocompatible alternatives.
Innovation Solution
A peritoneal dialysis solution comprising 0.02% to 0.05% carnitine, 0.50% to 2.50% xylitol, and optionally glucose, glycerol, or polydextrin, which maintains or restores the removal of small solutes and fluids, addressing membrane toxicity and ultrafiltration failure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stress or pressure
If glucose is used as the osmotic agent in peritoneal dialysis solution, then osmotic pressure is provided for fluid removal, but glucose oxidase converts glucose to gluconic acid causing pH decrease and bacterial growth promotion
Solution Approach 1:
The patent changes the chemical parameter of the osmotic agent from glucose to sucrose. Sucrose cannot be metabolized by glucose oxidase, so it maintains osmotic pressure without being converted to gluconic acid, thereby preventing pH decrease and bacterial growth while preserving the essential osmotic function.
Solution Approach 2:
The patent uses sucrose, a stable and inexpensive carbohydrate, as a replacement for glucose. Sucrose serves its osmotic function without undergoing enzymatic degradation, effectively acting as a non-renewable osmotic agent that maintains solution stability throughout the dialysis process.
2Use of energy by moving object
If glucose oxidase and catalase are added to the dialysis solution, then glucose metabolism is enabled, but solution pH decreases due to gluconic acid accumulation
Solution Approach 1:
The patent extracts glucose from the dialysis solution formulation and replaces it with sucrose. This removes the substrate that glucose oxidase would metabolize, thereby eliminating the production of gluconic acid and the associated pH decrease, while preserving the osmotic function needed for dialysis.
Solution Approach 2:
The patent introduces sucrose as an intermediary substance that fulfills the osmotic function without triggering the harmful metabolic pathway. Sucrose acts as a mediator that provides the necessary osmotic pressure without being converted to gluconic acid, thus maintaining pH stability.
3Productivity
If glucose is used as osmotic agent, then fluid removal is achieved, but glucose acts as carbon source promoting bacterial contamination
Solution Approach 1:
The patent changes the chemical identity of the osmotic agent from glucose to sucrose. This parameter change maintains the osmotic pressure necessary for fluid removal during dialysis while eliminating the carbon source that would promote bacterial growth, as sucrose cannot be metabolized by glucose oxidase.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The solution effectively maintains or restores the ability to remove small solutes and fluids, improving clinical outcomes by maintaining or restoring depurative efficacy and ultrafiltration in patients with end-stage renal disease and congestive heart failure.
Implementation Method 1
sucrose, which provides an osmotic gradient
Implementation Method 2
L-arginine and L-carnitine, which facilitate amino acid transport
Data Source
AI summary
The present invention relates to solutions for peritoneal dialysis for use for maintaining or restoring the removal of small solutes and fluids in subjects with end-stage renal disease and/or congestive heart failure. Such solutions comprise carnitine, xylitol and at least one of glucose, glycerol and polydextrin.